A population survey was carried out in Stockholm, Sweden, in 1967. In a sample of 15,268 individuals, 239 were found to have rheumatoid arthritis according to the New York diagnostic criteria. In 1983, i.e. 17 years later, 109 of the 127 individuals still living were reexamined. Among these, 79 complained of knee symptoms and 30 stated that the knee was the joint that presented the greatest hindrance to walking. Fifty-nine found difficulty in walking up or down stairs and 47 had to use a walking aid. These shortcomings were more often noted in the knees that had been swollen, or painful, 17 years previously. In addition, at follow-up, narrowing of the articular space was observed in the knees that were swollen and painful. Valgus deformity was associated with swelling, while varus deformity also involved, apart from the swelling, pain and restricted motility. In all, 108 operations were performed on 48 of the 109 subjects who were re-examined; 12 of these were knee operations.
Cardiogenic shock remains the leading cause of in hospital death in acute myocardial infarction (AMI) and is associated with a mortality rate of approximately 50%. Here we investigated the 17-year trends in incidence and prognosis of AMI-induced cardiogenic shock in Västra Götaland in western Sweden, an area with approximately 1.6 million inhabitants. The study period includes the transition from thrombolysis to primary percutaneous coronary intervention (PCI) as the region-wide therapy of choice for patients with ST-elevation myocardial infarction (STEMI).
Data on patients hospitalized in cardiac care units in Västra Götaland, Sweden between 1995 and 2013 were obtained from the Swedish Websystem for Enhancement of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). We determined the incidence of cardiogenic shock among patients diagnosed with AMI and the risk of death associated with developing cardiogenic shock. We fitted logistic regression models to study which factors predicted post-AMI cardiogenic shock. Analyses were performed on complete case data as well as after multiple imputation of missing data.
Incidence of cardiogenic shock as a complication of AMI declined in western Sweden in the past decade, from 14% in 1995 to 4% in 2012. The risk of dying once cardiogenic shock had developed increased during the study period (p
Renal transplantations have now been carried out at our hospital for just over 20 years. The results have gradually improved and are now very satisfactory. There are many explanations for this development, but the improvement in immunosuppression has probably been the most crucial development. Renal transplantation is cheaper and it provides greater wellbeing for the patient than does chronic dialysis treatment. The indications have been widened and the number of patients waiting for a new kidney is increasing. An improved retrieval of cadaveric kidneys will be necessary for the required expansion of kidney transplantation programmes.
Knowing which factors influence restoration longevity can help clinicians make sound treatment decisions. The authors analyzed data from The National Dental Practice-Based Research Network to identify predictors of early failures of amalgam and resin-based composite (RBC) restorations.
In this prospective cohort study, the authors gathered information from clinicians and offices participating in the network. Clinicians completed a baseline data collection form at the time of restoration placement and annually thereafter. Data collected included patient factors, practice factors and dentist factors, and the authors analyzed them by using mixed-model logistic regression.
A total of 226 practitioners followed up 6,218 direct restorations in 3,855 patients; 386 restorations failed (6.2 percent) during the mean (standard deviation) follow-up of 23.7 (8.8) months. The number of tooth surfaces restored at baseline helped predict subsequent restoration failure; restorations with four or more restored surfaces were more than four times more likely to fail. Restorative material was not associated significantly with longevity; neither was tooth type. Older patient age was associated highly with failure (P
Cites: J Am Dent Assoc. 2005 Jun;136(6):790-616022046
In the 1960s and early 1970s, coronary heart disease (CHD) mortality in Finland was the highest in the world, and within Finland, mortality was particularly high in the eastern part of the country. The North Karelia Project, the first large community-based cardiovascular diseases prevention program was established in 1972 to reduce the extremely high CHD mortality through behavioral change and reduction of the main cardiovascular disease risk factors among the whole population of North Karelia, the easternmost province of Finland. During the 40-year period from 1972 to 2012, smoking prevalence, serum total cholesterol, and systolic blood pressure declined markedly, except a small increase in serum cholesterol levels between 2007 and 2012. From the early 1970s to 2012, CHD mortality decreased by 82% (from 643 to 118 per 100,000) among working-age (35 to 64 years) men. Among working-age women, the decline was 84% (from 114 to 17 per 100,000). During the first 10 years, changes in these 3 target risk factors explained nearly all of the observed mortality reduction. Since the mid-1980s, the observed reduction in mortality has been larger than the predicted reduction. In the early 1970s, premature CHD mortality (35 to 74 years) was about 37% higher among Eastern Finnish men and 23% higher among Eastern Finnish women, compared with men and women in Southwestern Finland. During the last 40 years, premature CHD mortality declined markedly in both areas, but the decline was larger in Eastern Finland and the mortality gap between the two areas nearly disappeared.
In August 1991, three rural Alaska Public Health dentists made a professionally significant return visit to the Soviet Far East. The city of Magadan was the site for the first actual demonstration of portable American dental equipment and treatment techniques in this remote region of Russia. This exchange was held at several clinical locations and took place during the time of the attempted USSR government coup.